Provider Demographics
NPI:1013556307
Name:FIRST CHOICE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:FIRST CHOICE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VALARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLDHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:870-740-6698
Mailing Address - Street 1:PO BOX 45
Mailing Address - Street 2:
Mailing Address - City:BLYTHEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72316-0045
Mailing Address - Country:US
Mailing Address - Phone:870-740-6698
Mailing Address - Fax:870-838-1589
Practice Address - Street 1:827 E MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:BLYTHEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72315-2575
Practice Address - Country:US
Practice Address - Phone:870-763-8155
Practice Address - Fax:870-838-1589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy